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Ann Pediatr Endocrinol Metab > Accepted Articles
DOI: https://doi.org/10.6065/apem.2244210.105    [Accepted] Published online February 3, 2023.
Comparison of the effect of GnRH agonist dosage in girls with central precocious puberty
Shinyoung Jang1, Su Jin Kim1, Myeongseob Lee1, Hae In Lee2, Ahreum Kwon1, Junghwan Suh1, Kyungchul Song1, Hyun Wook Chae1, Ho-Seong Kim1 
1Department of Pediatrics, Division of Pediatric Endocrinology, Severance Children
2Department of Pediatrics, Gangnam Cha Hospital, Cha University School of Medicine, Pocheon, Korea
Address for correspondence:  Ho-Seong Kim
Email: kimho@yuhs.ac
Received: September 2, 2022   Revised: October 18, 2022   Accepted: October 27, 2022
There are no definite guidelines on the optimal dosage of gonadotropin-releasing hormone (GnRH) agonist for treatment of central precocious puberty (CPP). We compared growth outcomes of GnRH agonist at different dosages in girls with idiopathic CPP to assess the optimal dosage.
This retrospective study included 86 girls with idiopathic CPP who had been treated with GnRH agonist at least for 1 year and had attained their final adult height. Leuprolide was given as fixed dosage (3.75 mg every 4 weeks in body weight >20 kg, n=72) or weight-based dosage (60-85 μg/kg every 4 weeks, n=14). We compared suppression of advanced puberty and treatment response between the two groups.
Peak estradiol and luteinizing hormone and bone age (BA)/chronological age (CA) after injection of GnRH agonist were effectively suppressed in both groups. In both groups, the height standard deviation score (SDS) for BA increased after treatment. Final adult height (FAH) (fixed dosage group,160.8±4.1 cm and weight-based dosage group, 161.2±4.4 cm) was significantly higher than the initial predicted adult height (PAH) (155.5±3.3 and 156.1±3.6 cm, respectively) (both P<0.001) and similar to midparental height (159.8±3.3 and 160.6±3.7 cm, respectively). There were no differences in gain in height SDS for BA and gain in height (FAH-PAH at the start) between the two groups.
There were no differences in treatment outcome between fixed dosage (3.75 mg/4 wks) and weight-based dosage (60~85μg/kg/4wks) of GnRH agonist. Therefore, fixed dosage of GnRH agonist can be used more conveniently for CPP treatment without growth over-suppression.
Keywords: GnRH agonist, Administration and dosage, Precocious puberty, Treatment outcome


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